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Gastric accommodation and emptying in evaluation of patients with upper gastrointestinal symptoms
Open accessAbstract
Background & aims Endoscopy-negative dyspepsia is a common symptom that often is difficult to define in pathophysiologic terms. The aim of this study was to assess the frequency of disordered gastric accommodation and emptying in patients referred with unexplained upper gastrointestinal symptoms.Methods A computerized diagnostic index was used to identify all patients, 18-70 years old, who underwent single-photon emission computed tomography (SPECT) to assess gastric accommodation at Mayo Clinic Rochester over a 3-year period. Demographics, clinical features, and results of diagnostic testing, including scintigraphic gastric emptying, were extracted from the electronic record.Results A total of 214 patients were identified; the primary clinical diagnoses were functional dyspepsia, postfundoplication syndromes, rumination syndrome, and diabetic dyspepsia. Gastric accommodation was impaired in 43% of the whole group: 47% of functional dyspepsia, 44% of postfundoplication syndromes, and 33% of diabetic dyspepsia. Delayed gastric emptying was most prevalent in diabetic dyspepsia, and was accelerated in postfundoplication syndromes groups. Thirty-seven percent of patients had abnormal gastric emptying. The highest prevalence of delayed gastric emptying was in the diabetic dyspepsia and accelerated gastric emptying in postfundoplication syndromes groups. Twenty-five percent of patients with normal gastric emptying had impaired accommodation. Upper-gastrointestinal symptoms were not different in groups based on gastric accommodation or emptying results.Conclusions Impaired gastric accommodation is common in patients with unexplained dyspepsia. Symptoms alone cannot predict physiologic disturbances. These noninvasive tests identify single or combined pathophysiologic disturbances and may help to identify subgroups of patients as candidates for more selective pharmacotherapy in the future.
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“Altered GI motility and transit have long been recognized in the pathobiology of FGIDs such as IBS48 and functional dyspepsia (FD)49, 50.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [50]
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Metadata
- Authors
- Bredenoord, A. J., Chial, H. J., Camilleri, M., Mullan, B. P., & Murray, J. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Camilleri, Michael
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 1
- Issue
- 4
- Pages
- 264-272
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2159492794
- Cited by
- 243
- References
- 44
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 13 · 2020: 12 · 2019: 15 · 2018: 11 · 2017: 7 · 2016: 9 · 2015: 10 · 2014: 8 · 2013: 11 · 2012: 10
- FWCI
- 14.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K24 DK02638, R01 DK-54681, R01 DK57982, K24DK002638, R01DK054681)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- gastric accommodation, gastric emptying, functional dyspepsia, rumination syndrome, gastric emptying scintigraphy, upper gastrointestinal symptoms
- MeSH terms
- Adolescent, Adult, Aged, Diabetes Mellitus, Dyspepsia, Fasting, Female, Gastric Emptying, Gastroesophageal Reflux, Gastrointestinal Motility, Humans, Male, Manometry, Middle Aged, Minnesota, Recurrence, Tomography, X-Ray Computed, Cohort Studies, Tomography, Emission-Computed, Single-Photon, Endoscopy, Gastrointestinal, Treatment Outcome, Ultrasonography, Interventional, Fundoplication, Postprandial Period, Upper Gastrointestinal Tract
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